This week’s question is from a reader who’s ticked off at a doctor. Literally.
On April 29, I went to a walk-in clinic to have a tick removed from my head (I could not remove it because I could not see it) and on Friday, May 31, I received a bill for $750 to be paid by May 28. Is this normal, and is there anyone who can help me? Am I to blame for not asking the cost of this before they helped me? I am in my 60s, and this has been so stressful. — Sara
If this story had been about any business other than health care, I would have thought this reader was pulling my leg, because the price is so out of line with the service received. But because it concerns medical costs, I find it not only believable, but likely.
Exactly what are these services worth?
A couple of years ago I had a high fever and couldn’t immediately get in to see my doctor. I was in such misery, I drove myself to a nearby hospital emergency room. After a few hours, a few tests and a shot of antibiotics, I was on my way.
Several days later I got the bill: $2,400.
My first call was to the hospital, and my first question was if they’d sent their bill through my health insurance company. They said no, their records reflected I was uninsured. I explained that I was insured and provided my health insurance information.
A few weeks later, I got a new bill: $600.
Despite having insurance, I had to pay the $600, because my deductible was $6,000. But where else in America does a vendor charge one customer $600 and another $2,400 for the exact same service? Imagine how you’d feel if you paid $50,000 for a new car, then found out I’d bought the same car from the same dealer on the same day for $12,500.
The services the hospital supplied were presumably profitable at $600; otherwise they wouldn’t have agreed to that rate with my insurance company. Yet they had no problem charging an uninsured person 300 percent more. And if that person was unwilling or unable to pay this inflated bill? The account would go to collections, the collection agency would sue and get a judgment and that person’s credit would be ruined.
Time magazine reporter Steven Brill made the talk show circuit in 2013 after writing a comprehensive story about this exact issue: hyper-inflated medical bills ostensibly created out of thin air and in no way related to the cost of the services provided. While Brill did a great job on his story, the subject is nothing new. We covered it in 2009: See “Killer Hospital Bills.”
Sara asks, “Am I to blame for not asking the cost of this before they helped me?” Answer: We should all ask the price of anything before agreeing to it.
When it comes to health care, however, that’s often easier said than done. Sure, Sara could have asked the cost for tick removal and, after being beaten up this way, it’s likely she’ll do so in the future. But how could I get an advance quote on fixing my fever when the services needed to be performed before the cause was known? Even if I hadn’t been practically delirious, there was no way for me to comparison shop.
What should Sara do?
The first thing Sara should do is what every consumer should do when confronted with any bill that feels unfair. Contact the person responsible, calmly explain the situation and, in the friendliest possible way, ask to have the bill reduced. Whether it’s a plumber, a restaurant or a doctor, you have every right to question a bill and ask for an adjustment if the cost is unreasonable in relation to the services provided.